Contributors Y-HW and Y-WC developed the study protocol. All authors jointly conducted the study, analysed data, and wrote the paper.
Y-WC is the guarantor.

Received 30 November 2011

Accepted 11 April 2012

Published Online First 12 May 2012

Abstract

Introduction The Cochrane Library is the most important online evidence retrieval database of systematic reviews. Since 2007, the National
Health Research Institutes has offered Taiwan's regional hospitals free access to the Cochrane Library. This study investigated
how these hospitals disseminate its utilisation.

Methods The usage rate of Cochrane reviews was measured in the participating hospitals from January 2008 to December 2009. Thereafter,
a questionnaire survey was conducted for each regional hospital disseminator at the beginning of 2010 to analyse their methods
of disseminating Cochrane reviews.

Results The hospitals were stratified into three groups according to the relative rate of access: high (n=15), medium (n=16) and
low (n=13). In comparison with the low-usage hospitals, the high-usage hospitals tended to assign a disseminator of evidence-based
medicine to take charge of the dissemination of Cochrane reviews (p<0.001). In addition, the high-usage hospitals more often
used the following six methods: providing relevant information via email (p<0.05), investing in early adopters (p<0.05), using
assistance from designated personnel (p<0.05), highlighting the activity of early adopters (p<0.05), conducting workshops
(p=0.001), and inviting experts to speak (p<0.001). There was no significant difference between high- and low-usage hospitals
in organisational barriers.

Conclusion This study has identified several helpful strategies used by Taiwan's hospitals to enhance dissemination of the Cochrane
Library, including raising of awareness, active delivery of information, mentoring relationships, and educational training.
The data suggest that disseminating evidence-based medicine simultaneously is a key element.